Yan Hai-Tao, Lu Guang-Dong, Zhang Jin-Xing, Zhou Chun-Gao, Liu Jin, Liu Sheng, Shi Hai-Bin, Zu Qing-Quan
Department of Interventional Radiology, The First Affiliated Hospital With Nanjing Medical University, Nanjing, 210029, China.
Department of Clinical Medicine Research Institution, The First Affiliated Hospital With Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China.
Cardiovasc Intervent Radiol. 2023 Mar;46(3):369-376. doi: 10.1007/s00270-023-03361-w. Epub 2023 Jan 19.
To compare the safety and effectiveness between bronchial artery embolisation (BAE) and conservative treatment for bronchiectasis-related nonmassive haemoptysis patients.
From January 2015 to December 2020, consecutive bronchiectasis-related nonmassive haemoptysis patients who underwent either BAE (n = 98) or conservative treatment (n = 118) were included. Treatment-related complications, length of hospital stays, clinical success rate, patient satisfaction, and recurrence-free survival rates were compared between groups. Prognostic factors related to recurrence were also analysed.
During a median follow-up time of 44.8 months (range, 2.4-83.6 months), 34 and 66 patients in the BAE and conservative treatment groups suffered relapse. The 1-year, 2-year, 3-year and 5-year haemoptysis-free survival rates in the BAE and conservative treatment groups were 79.2%, 68.1%, 62.8%, and 57.6% and 64.0%, 52.8%, 44.1%, and 37.0%, respectively (P = 0.007). The minor complication rate after BAE was higher than that after conservative treatment (23/98 vs. 12/118, P = 0.008). BAE was associated with shorter hospital stays (5.0 vs. 7.0 days, P = 0.042) and higher patient satisfaction (88.8% vs. 74.6%, P = 0.008) than those for conservative treatment and with comparable clinical success rates (95.9% vs. 91.5%, P = 0.192). Treatment type, haemoptysis duration, and bronchiectasis severity were independently significant predictors of recurrence for these patients.
BAE could be another option for bronchiectasis-related nonmassive haemoptysis patients. In the patients with longer duration and more severe bronchiectasis, BAE still appeared to have better long-term haemoptysis control than conservative therapy.
比较支气管动脉栓塞术（BAE）与保守治疗在支气管扩张症相关非大量咯血患者中的安全性和有效性。
纳入2015年1月至2020年12月期间连续接受BAE治疗（n = 98）或保守治疗（n = 118）的支气管扩张症相关非大量咯血患者。比较两组的治疗相关并发症、住院时间、临床成功率、患者满意度和无复发生存率。还分析了与复发相关的预后因素。
在中位随访时间44.8个月（范围2.4 - 83.6个月）内，BAE组和保守治疗组分别有34例和66例患者复发。BAE组和保守治疗组的1年、2年、3年和5年无咯血生存率分别为79.2%、68.1%、62.8%和57.6%以及64.0%、52.8%、44.1%和37.0%（P = 0.007）。BAE后的轻微并发症发生率高于保守治疗（23/98 vs. 12/118，P = 0.008）。与保守治疗相比，BAE的住院时间更短（5.0天vs. 7.0天，P = 0.042），患者满意度更高（88.8% vs. 74.6%，P = 0.008），临床成功率相当（95.9% vs. 91.5%，P = 0.192）。治疗类型、咯血持续时间和支气管扩张严重程度是这些患者复发的独立显著预测因素。
BAE可能是支气管扩张症相关非大量咯血患者的另一种选择。在咯血持续时间较长且支气管扩张较严重的患者中，BAE在长期控制咯血方面似乎仍比保守治疗更好。
